Medicare Library

HMSA Medicare Advantage Plans

• HMSA Akamai Advantage®
• HMSA Akamai Advantage Dual Care (PPO D-SNP)
• HMSA Akamai Advantage Select Plus (HMO)

HMSA Medicare Advantage Plans

• HMSA Akamai Advantage Plans

HMSA Medicare Advantage Plan Comparison

• Medical Plans:
  • 2027 Plan Comparison for Providers [PDF]
  • 2026 Plan Comparison for Providers [PDF]
  • 2025 Plan Comparison for Providers [PDF]

Appeals

• Medicare Advantage Provider Appeals
• HMSA Akamai Advantage Non-Contracted Provider Appeals

Claims Mailing Address Information:

• HMSA Directory – Claims

Fee Schedules

• Medicare Fee Schedule HMSA Akamai Advantage pays according to the Medicare Fee Schedule, found here through our intermediary. To the extent an Average Sales Price file is utilized, HMSA carries two places after the decimal point for calculation of the amount due for a line item, then follows standard rounding procedures in determining the final payment amount.

Forms

• Forms Index
• HMSA Medicare Advantage Dual Care Attestation Form [PDF]

Medicare Diabetes Prevention Program

• Medicare Diabetes Prevention Program

Medicare Star Ratings

• Medicare Risk Adjustment and STARs (Video) – September 2021
• Medicare Risk Adjustment and STARs [PDF] – September 2021
• Medicare Star Ratings

Notifications

• Provider Practices [PDF] Centers for Medicare & Medicaid Services (CMS) Guidelines for distributing marketing collateral.
• Correct Billing Instructions for Modifiers GA, GX, GY and GZ
• Two-Midnight Rule and Observation Room Implementation and Billing [PDF]
• HMSA Medicare Advantage Diabetic Test Strips

Pharmacy and Formulary

• Formularies for Medicare Advantage Plans

Precertification/Prior-authorization:

• Precertification Requirements – Medicare Advantage Plans
• Durable Medical Equipment (DME) Codes Requiring Prior Authorization for Medicare Advantage (PPO/HMO)
• Plan-Directed Care Prior Authorization Checklist [PDF]

Sequestration

• Sequestration

Training

• Medicare Advantage Overview Presentation
  • Medicare Advantage Annual Provider Training 2027 – October 2026 (Video) Coming soon
  • Medicare Advantage Annual Provider Training 2027 – October 2026 [PDF] Coming soon
  • Medicare Advantage Annual Provider Training 2026 – October 2025 (Video)
  • Medicare Advantage Annual Provider Training 2025 – October 2024 (Video)
  • Medicare Advantage Annual Provider Training 2025 – October 2024 [PDF]
• Medicare Parts C and D Fraud, Waste and Abuse and General Compliance Training
  • CMS Medicare Parts C and D General Compliance Training [PDF]
  • CMS Combating Medicare Parts C and D Fraud, Waste and Abuse Training

Revision History